Mroczkowski Megan M, McReynolds Larkin S, Fisher Prudence, Wasserman Gail A
Drs. Mroczkowski and McReynolds are Assistant Professors of Psychiatry and Dr. Wasserman is a Professor of Medical Psychology (in Psychiatry), Columbia University Medical Center, New York, NY. Dr. Fisher is Associate Professor of Clinical Psychiatric Social Work (in Psychiatry) at Columbia University College of Physicians and Surgeons, New York, NY. Versions of this study were presented as a poster at the 45th Annual Meeting of the American Academy of Psychiatry and the Law, Chicago, October 23-26, 2014, and at the 63rd Annual Meeting of the American Academy of Child and Adolescent Psychiatry, New York, October 24-29, 2016.
J Am Acad Psychiatry Law. 2018 Sep;46(3):329-338. doi: 10.29158/JAAPL.003767-18.
Disruptive mood dysregulation disorder (DMDD) is a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). We compared juvenile justice involved youths with DMDD to those with disruptive behavior disorders (DBDs) and other mood disorders, to clarify the differences and to investigate differential correlates to DMDD relative to DBDs or mood disorders. Diagnostic and demographic data were available for 9,819 youths served by 57 juvenile justice sites. A subsample of 2,498 youths had data relevant to our study. The youths self-assessed mental health status on the Voice Diagnostic Interview Schedule for Children (V-DISC), and we retrofitted the V-DISC data to derive an approximate DMDD diagnosis. The retrofitted criteria for DMDD were met by 3.3 percent of justice-involved youths. Results from multinomial regression showed that, after adjustment for covariates, those with DMDD had fewer differences compared with those with other mood disorders than did those meeting criteria for DBDs. Consistent with the DSM-5 classification of DMDD as a depressive disorder, those with DMDD shared more characteristics with youths with mood disorders than with those reporting DBDs. Externalizing behaviors leading to justice involvement may overshadow internalizing symptoms of DMDD, but mood-related conditions should be identified and treated in this population.
破坏性情绪失调障碍（DMDD）是《精神疾病诊断与统计手册》（DSM - 5）中的一种新诊断。我们将患有DMDD的涉青少年司法系统的青少年与患有破坏性行为障碍（DBD）和其他情绪障碍的青少年进行比较，以明确差异，并研究与DBD或情绪障碍相比，DMDD的不同相关因素。57个青少年司法场所为9819名青少年提供了诊断和人口统计学数据。2498名青少年的子样本拥有与我们研究相关的数据。这些青少年通过儿童语音诊断访谈量表（V - DISC）自我评估心理健康状况，我们对V - DISC数据进行改造以得出近似的DMDD诊断。3.3%的涉司法青少年符合改造后的DMDD标准。多项回归结果显示，在对协变量进行调整后，与符合DBD标准的青少年相比，患有DMDD的青少年与患有其他情绪障碍的青少年之间的差异更小。与DSM - 5将DMDD归类为抑郁障碍一致，患有DMDD的青少年与患有情绪障碍的青少年有更多共同特征，而与报告患有DBD的青少年相比则不然。导致涉司法的外化行为可能会掩盖DMDD的内化症状，但在这一人群中应识别并治疗与情绪相关的状况。
